The trajectory of hope: pathways to find meaning and reconstructing the self after a spinal cord injury.

Abstract

This is a qualitative study. To evaluate and track the importance and the continuum of hope, and its trajectory, from the point of view of the individual with a spinal cord injury (SCI) and a rehabilitation psychologist. This study was conducted in the Indian Spinal Injuries Centre, New Delhi, India, and in patients' homes in the National Capital Region, India. Twenty individuals with an SCI were interviewed for the study at intervals of 2 weeks, 6 months, 1 year and 2 years since the time of the injury. Semi-structured interviews were conducted, in which the following theoretical research questions were investigated: 'What is the meaning, relevance and significance of hope in the individual's life following an SCI? Does the meaning and subject of hope change at different points in time?' Three distinctive themes markedly emerged in the trajectory of hope: (1) Hope for a complete recovery; (2) hope for self-reliance despite the injury; and (3) hope for an optimum quality of life. The make-up of each theme, its significance and contribution to recovery and/or rehabilitation, while tracking the influence of time since injury, family and friends, as well as other agencies and pathways, are discussed. After sustaining a life-altering injury, hope becomes the force that spurs individuals. Psychologists and rehabilitation counselors need to focus on instilling realistic hope, goal setting, sustaining motivation, enabling adaptive appraisals and problem-solving. Further recommendations include developing and testing interventions against the context of the continuum of hope.